Expert Opinions: Toe Hemiarthroplasty vs. Fusion

June 30, 2016

The standard toe fusionof care for advanced toe arthritis has always been arthrodesis. Historically, scientific literature favored joint fusion, however, metatarsal based implants have now been in use for over a decade allowing motion preserving joint replacements to gain traction for the treatment of Hallux Rigidus.

A recent systematic review of peer review literature showed that  Toe HemiCAP® implant surgery had a larger impact on patients’ pain relief when compared to fusion. Patients’ satisfaction was also rated higher with joint replacement when compared to fusion. Joint arthrodesis is considered an end stage procedure in all other joints, however, in the toe it is still considered as a primary procedure. Particularly for patients with mobile arthritis, it may be time to rethink the treatment approach as the published reoperation rate for fusions was 3 times higher than the metatarsal based HemiCAP implantations. Based on these literature results, HemiCAP joint resurfacing surgery may be a suitable alternative to fusion and should be considered as a first implant for Grade II and III Hallux Rigidus.

toe fusion alternatives

35 responses to “Expert Opinions: Toe Hemiarthroplasty vs. Fusion”

  1. Margaret says:

    Hi! I have stage 1 hallux limitus & would like to have the option of getting the Hemi Cap system. I don’t want to wait until it gets to stage 2 with more damage & more pain! Please advise.

  2. C W says:

    I would like to an evaluation for this treatment for Hallux Ridgidus,limitus occurred after bunion surgery .

    • arthrosurface says:

      Hi CW, We sent you an email a few weeks ago with additional information. Please let us know if you did not receive it.

  3. Kenny Cummings says:

    I have stage 3-4 hallux ridgidus I have been told I need A fusion.Are there any doctors in the Clear lake ,Texas area that hove A history
    With this hemi cap procedure.

  4. Dawn says:

    I’m looking for more information and a physician in my area.

  5. Would love to learn if there are surgeons performing this in Springfield MASSACHUSETTS…

  6. Nathan Phillips says:

    Hi. I’m a very active 40yr old who does not want to stop sprinting, rugby, squash etc. I have been diagnosed with moderate arthritis in my big toe with fusion beint touted as my best option. Can you advise whether there is an experienced surgeon in the East Midlands of the UK I could contact?

  7. Julie says:

    I am an active, running, tennis playing 54 year old lady and would like info on surgeons in the Atlanta area that use the hem I cap procedure. I have a bone spur in the joint of my big toe and have been told I’ll need fusion surgery.

  8. Arlene Visser says:

    Hi I’ve been told my only option for Hallus Rigidus is a fusion. I’m an active squash player and only 41 years old. I’m looking for the best option for long-term pain relief where I will still be able to play squash. I live in Namibia, Africa.

  9. Jason Bennett says:

    Hi I am 47 years old and have been told that my only option is fusion for my Hallux Rigidus. I want the best option as for pain relief and being able to continue with sports. I live in Birmingham, England.

  10. Renee Burns says:

    I have my first 3 toes fused and hate it. Is there such a thing as reversal that would give function ability again?

  11. Kathy Kennedy says:

    I had A Cartiva implant a year ago because I had cartilage damage on my big toe. It has not relieved the pain and a doctor recommended Hemi cap over fusion due to my active lifestyle.

    How are the results when done as a revision to cartiva?

    Do you know doctors in the Pleasanton/San Ramon/Danville area that have done this procedure?

  12. Jul8a says:

    Please send info comparing hemicap to Cartiva and listing surgeons in Austin Texas experienced in this procedure.

  13. Linda Murphy says:

    I had a Cartiva implant may 2019. I’m in constant pain . Dr said last X-ray the implant was in place. I am miserable. I’ve tried NSAI and an injection – nothing is helping. Please advise

  14. Christine Greene says:

    Im in New Orleans and would love to learn more! My doc at the VA is suggesting fusion but Im 40 not 80!

  15. CookieSue says:

    I am a 69-year-old active female with diagnosed first metatarsophalangeal joint arthritis (Radiographs are independently interpreted, and reveal significant narrowing of the right first metatarsophalangeal joint, dorsal first metatarsal exostosis, and irregularity with sclerosis indicating severe osteoarthritis). An evaluation several months ago recommended fusion as my only option, which I did not receive very well. Would this type of implant be useful for my condition since I love to country line dance and feel fusion would limit this activity.

  16. BRENDA DEIBERT says:

    Please send me info on arthrosurface. I have severe osteoarthritis in great toe.

  17. BJ Tompkins says:

    Do you have any doctors in Australia that are doing this procedure? I have been told I require a fusion in my left great toe. I’m 43 years old and want to maintain movement in the joint.

  18. Ivana Matteo says:

    Hi, I had 2 surgeries on my big toe die to advancing arthritis. The last surgery was 7 years ago. I had a xenograft implant. It has now worn out and I was told the next step is likely a fusion. Can you send me information on this implant and surgeons who perform it in the Bergen county, nj area please?

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